Mapa mental
Hypertension
Contenido del mapa
Hypertension
define as a systolic bp of 140 mmHg or ↑ and diastolic bp of 90 mmHg or ↑
Primary Hypertension: aka "essential"; affects 95% of pts; unidentifiable cause
Secondary Hypertension: affects 5% of pts; renal disease; sleep apnea; pregnancy related
Prevalent in African American community
Usually no symptoms however symptoms related to organ damage are seen late and are serious i.e → retinal/eye damage; renal damage; MI; cardiac hypertrophy; stroke
Patient Assessment
- History and Physical Exam: retinal exam
- Lab Tests: urinalysis; blood chemistry
- ECG
Management
- HTN can never be cured but can be maintained
- maintain bp: <140/90; <150/90 (older adult); Lifestyle Modifications: weight reduction; DASH diet; decrease sodium intake; regular physical activity; reduced alcohol consump.
- Stage I HTN: usually given thiazides for treatment
- Pharmacologic therapy: ↓ peripheral resistance & blood volume; ↓ strength and rate of myocar. contraction; Meds= diuretics; beta blockers; alpha1 blockers, ace inhibs., vasodilators, calcium channel blockers,
- Diuretic: decreases serum sodium levels and BV
- ACE Inhibs: blocks conversion of angiotensis I to II; blocks effects of angiotensin on blood vessels
- Beta-Blockers: decrease HR and contraction strength and vasodilates
- Calcium Channel Blockers: relaxes muscle contraction or other autonomic blockers
- Vasodilators: acts on vascular smooth muscle causing muscle relaxation, leads to vasodilation and ↓ BP